Imad E. Khadra, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

01036728 Issued in IN

Practice address

3920 St Francis Way Ste 220
Lafayette, IN 47905

Phone

(765) 502-4110

Fax

(765) 428-5951

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Critical Care (Intensivists)

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109
• Franciscan Health Rensselaer, Inc Hospital, Rensselaer, IN, CCN 151324
• Franciscan Health Crawfordsville Hospital, Crawfordsville, IN, CCN 150022
• Memorial Hospital Hospital, Logansport, IN, CCN 150072

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ikhadra5547@direct.franciscanalliance.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment Care Compare group NPD
• State of Indiana, Auditor of State

  • Psychiatric Hospital
  • Madison, IN
  • NPI 1700876224
  Medicare reassignment NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD
• State of Indiana Auditor of State

  • Nursing Facility/Intermediate Care Facility
  • West Lafayette, IN
  • NPI 1194778001
  NPD
• State of Indiana, Auditor of State

  • Public Health or Welfare Agency
  • Indianapolis, IN
  • NPI 1023613403
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health Crawfordsville

  • General Acute Care Hospital
  • Crawfordsville, IN
  • NPI 1588774558
  Care Compare affiliation
• Franciscan Health Lafayette

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1356435341
  Care Compare affiliation
• Franciscan Health Rensselaer, Inc.

  • Critical Access Hospital
  • Rensselaer, IN
  • NPI 1932589173
  Care Compare affiliation
• Parkview Logansport Hospital Inc

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1356320469
  Care Compare affiliation
• St. Clare Medical Center

  • Skilled Nursing Facility
  • Crawfordsville, IN
  • NPI 1508960535

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1205855418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 ST FRANCIS WAY STE 220",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905",
            "telephone_number": "765-502-4110",
            "fax_number": "765-428-5951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2708 Ferry St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479043021",
            "country_code": "US",
            "telephone_number": "765-446-1571",
            "fax_number": "765-447-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHADRA",
        "first_name": "IMAD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01036728",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01036728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100087520",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M400062471",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ikhadra5547@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3920 St Francis Way Ste 220",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pulmonary Disease Physician in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Pulmonary Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.